Initial Neck Exploration for Untreated Hyperparathyroidism

Martin, II, Robert C.G.; Greenwell, Darren; Flynn, Michael B.
March 2000
American Surgeon;Mar2000, Vol. 66 Issue 3, p269
Academic Journal
This study represents the experience of the Department of Surgery at the University of Louisville over a 21-year interval. Many aspects of surgical management of hyperparathyroidism have changed over the last 2 decades; controversies regarding the extent of exploration and the value of preoperative localization studies remain unresolved. One hundred ninety-three patients underwent neck exploration for hyperparathyroidism from 1976 to 1997. Data were collected from four University of Louisville-affiliated hospitals by independent evaluators. One hundred sixty patients with untreated hyperparathyroidism underwent neck exploration. Preoperative localization was carried out in 52 per cent (83 of 160). The exact location of the abnormal gland was indicated in 55 per cent (46 of 83), and the correct side of the neck was identified in 74 per cent (61 of 83). Technetium sestamibi scan was most reliable and identified the abnormality in 83 per cent (24 of 29). The average operative time with preoperative localization was 118 minutes compared with 137 minutes without preoperative localization. Intraoperative methylene blue was used in 42 of 160 neck explorations. Average operative time with methylene blue was 102 minutes compared with 124 minutes without methylene blue. Thirty-seven per cent (59 of 160) of patients underwent unilateral neck exploration. Sixty-three per cent (101 of 160) underwent bilateral exploration. Successful exploration was conducted in 98 per cent of the unilateral group and 91 per cent of the bilateral group. Postoperative local complications were essentially the same in both groups (3%), whereas temporary hypocalcemia occurred in 24 per cent (24 of 101) of the bilateral group compared with 3 per cent (2 of 59) of the unilateral group. We conclude that neck exploration for hyperparathyroidism is a highly successful, safe treatment with no mortality and minimal morbidity. Preoperative localization studies modestly reduced the duration of surgery wit...


Related Articles

  • Primary hyperparathyroidism in pregnancy: a case series and review. Truong, M. T.; Lalakea, M. L.; Robbins, P.; Friduss, M. // Obstetric Medicine (1753-495X);Jun2009, Vol. 2 Issue 2, p88 

    The article offers information on the study regarding the prevalence of primary hyperparathyroidism in pregnant women, which gives emphasis on the relative benefits of surgery.

  • Surgical anatomy of the parathyroid glands in secondary hyperparathyroidism. Butterworth, P.C.; Nicholson, M.L. // Journal of the Royal College of Surgeons of Edinburgh;Aug98, Vol. 43 Issue 4, p372 

    Examines the surgical anatomy of the parathyroid glands in secondary hyperparathyroidism in Great Britain. Descriptions of parathyroid anatomy based on studies of normal glands; Presentation of the details parathyroid anatomy of patients; Comparisons on the anatomical locations in series of...

  • Cost utility of routine imaging with Tc-99m-sestamibi in... Wei, John P.; Burke, George J. // American Surgeon;Dec1997, Vol. 63 Issue 12, p1097 

    Analyzes the cost effectiveness of Tc-99m-sestamibi radiologic test before initial surgery for primary hyperparathyroidism. Clinical procedures used for the patients in the study; Statistical analysis of the data; Discussion on the research findings; Conclusions; Commentaries and questions of...

  • Initial cervical exploration for parathyroidectomy is not benefited by preoperative localization... Roe, S. Michael; Brown, Preston W.; Pate, Linda M.; Summitt, J. Blair; Ciraulo, David L.; Burns, R. Phillip // American Surgeon;Jun1998, Vol. 64 Issue 6, p503 

    Reports on the outcome of a six-year review of a surgeon's experience to determine whether preoperative localization studies are beneficial to the initial surgical management of patients with primary hyperparathyroidism (PHPT). Patient costs of localization studies; Preoperative localization...

  • An Analysis of Sestamibi-Positive versus -Negative Patients with Primary Hyperparathyroidism. Parel, Robert J.; Bolton, John S.; Fuhrman, George M. // American Surgeon;Nov2001, Vol. 67 Issue 11, p1101 

    We performed this study to evaluate two patient groups with primary hyperparathyroidism depending on whether their abnormal gland(s) could be preoperatively imaged with sestamibi. Patients with primary hyperparathyroidism evaluated by preoperative sestamibi examination from January 1999 to June...

  • 5th biennual congress of the European Society of Endocrine Surgeons (ESES) Gothenburg Sweden, May 24-26, 2012.  // Langenbeck's Archives of Surgery;Jun2012, Vol. 397 Issue 5, p843 

    The article presents abstracts on medical topics which include morbidity followed by thyroid surgery, random trial of hemithyroidectomy versus Dunhill for asymmetrical goiter, and improvement in bone mineral density after operation for primary hyperparathyroidism.

  • Minimally invasive parathyroidectomy for primary hyperparathyroidism: Decreasing operative time... Norman, James; Chheda, Hemant; Farrell, Connie // American Surgeon;May1998, Vol. 64 Issue 5, p391 

    Evaluates the efficacy and safety of unilateral neck exploration for patients with hyperparathyroidism (HPTH) and adenoma. Results of the sestamibi scans of the patients; Anesthetic technique applied; Decrease of the total operative time; Successful application of the minimally invasive...

  • Using Surgery to Treat Hyperparathyroidism. Kirchner, Jeffrey T. // American Family Physician;2/15/2000, Vol. 61 Issue 4, p1141 

    Discusses two studies about the effectiveness of surgery as treatment for hyperparathyroidism published in the October 21, 1999 issue of the `New England Medical Journal.' `A 10-Year Prospective Study of Primary Hyperparathyroidism With or Without Parathyroid Surgery,' by S.J. Silverberg and...

  • Minerva.  // BMJ: British Medical Journal (International Edition);03/14/98, Vol. 316 Issue 7134, p872 

    Looks at several medical facts and information. Increase in surgery for primary hyperparathyroidism in Australia; Account on depression in smokers; Relationship between cancer incidence in children and area of living; Information on artificial nail use in the United States.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics